Billing code 52281: Urethral dilationMedicare rate & RVUs

Medicare pays $310.29 for 52281 nationally in the office and $136.61 in a hospital or facility. Local office rates run $275.03–$406.83.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 52281 covers

A urologist uses a cystoscope to evaluate a narrowed urethral segment and calibrate or widen it with suitable dilators. The procedure may also include a meatotomy when the narrowing involves the urethral opening. It is performed for urethral stricture or stenosis associated with symptoms such as impaired urinary flow, in an office or facility setting depending on the clinical circumstances and resources.

Report this code when the documented treatment is cystoscopic calibration or dilation of a urethral narrowing, whether or not meatotomy is performed. The record should identify the stricture or stenosis, its location when known, the treatment performed, and any meatotomy. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS applies endoscopy-family pricing. Report a single procedure rather than modifier 50; the descriptor and anatomy do not support bilateral reporting. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 52281 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

52281 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 52281 rate is calculated

Each of 52281’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 52281

The CMS indicators that decide how 52281 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

52281 compared with similar codes

How to choose

52276Urethral stricture treatment

52281 represents cystoscopic calibration or dilation, potentially with meatotomy. Choose 52276 when the documented treatment is direct-vision incision of the stricture.

52284Urethral dilation

52284 describes cystoscopic treatment using a drug-coated balloon. 52281 is the code for calibration or dilation without that specific balloon treatment.

53600Urethral dilation

53600 describes urethral dilation by passage of a sound or dilator. 52281 includes cystoscopic evaluation and treatment of the narrowing.

52270Urethrotomy

52270 is for cystoscopic urethral meatotomy. 52281 is for calibration or dilation of a stricture or stenosis, with meatotomy permitted as part of that service.

Codes related to 52281

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates